| Abstract: | 30 cases of congenital hypothyroidism arc ana-Iysed. The female to male ratio was l.7:1 and the ageranged from newborn t0 12 years, 12 being infantsbelow 2 years. Most cases had classical symptomsand signs. In 25 cases with serum T4 radioimmunoassay T4 was less than normal in 23, and in 13 caseshaving serum TSH determinations TSH was elevatedbefore thyroid therapy. Combined use oF thyroidscan with technetium-99m pertcchnetate and low dosei3iI thyroidal uptake in the anatomic diagnosis ofetiology and assessment of thyroid activity wasstressed. In the series the misdiagnosis rate was16.6%. It is imperative to recognize the compensated form of congenital hypothyroidism, since theclinical manifestations may be subtle, with nearnormal serum T4 and T3, but definitely increassedserum TSH. Owing to the instability of the con-tent of desiccated thyroid and patient individualrequirements and reactivity, dosage should be in-dividualized. Concomitant infections should betreated in time, special precautions should be takenagainst latent myxedematous heart disease in hypothyroid infants in whom daily fluids should be re-stricted with conservative doses of thyroid general-ly at the beginning of treatment. The results oftreatment were excellent in our series. |
